Nursing Education and Advance Level Practicum Experience
What are Advanced Level Practicum Experiences
Advanced level nursing education programs provide rich and varied opportunities for practice experiences (both direct and indirect care experiences) to prepare graduates with the Level 2 sub competencies as well as applicable advanced nursing practice specialty/advanced nursing practice role competencies and requirements, Practice Experiences build on Level 1 sub-competency achievement and are designed to assist the graduate to achieve Level 2 sub-competencies and applicable specialty competencies upon completion of the program.
Practice experiences are required to integrate didactic learning, promote innovative thinking, and test new potential solutions to clinical practice or system issues. Therefore, the development of new skills and practice expectations can be facilitated through the use of creative learning opportunities in diverse settings.
All graduates of advanced-level nursing education programs have structured, faculty designed practice experiences, which may include prescribed experiences with faculty oversight and/or experiences with direct faculty supervision. The program is responsible for providing sufficient and appropriate clinical sites/placements for students to demonstrate attainment of Level 2 sub-competencies and applicable specialty competencies.
Clinical/practice learning experiences may be accomplished through diverse methodologies, including simulation and virtual technology, and assist the graduate to develop greater proficiency in these competencies, including cognitive, psychomotor, and affective competencies. Use of simulation should align with specialty requirements.
All advanced education practicum experiences must have faculty oversight and be verified and documented as a component of a formal course or plan of study. Programs provide practice placements that are safe, supportive, and conductive for learning. The nursing program faculty determine and assess practice sites to ensure that the site supports student learning with the intended population or scope of practice.
Faculty, students, and preceptors must be well informed about the specific competencies that are integrated in the didactic, laboratory, and practice experiences and the method(s) to assess the achievement of the competencies.
Competency Attainment and Practice Experiences
All learners in advanced nursing education programs engage in practical learning activities (both direct and indirect care experiences). Graduates of all advanced nursing education programs need sufficient clinical/practice experiences to demonstrate end of program student outcomes, Level 2 sub-competencies, and competencies required by applicable national, specialty organizations and/or for national advanced nursing practice specialty or advanced nursing practice role certification. Programs document clear evidence of competence achievement.
Advanced Education Clinical/Practice Hours
The application of competency-based education to prepare advanced nursing professionals inherently calls to question the role of more traditional time based requirements. In this Essentials model, there is an emphasis on ensuring that all nurses pursuing advanced education attain Level 2 sub-competencies as well as competencies required for an advanced nursing practice specialty or advanced nursing practice role being pursued.
The number of required practice (direct and indirect care) hours vary based on advanced specialty/role requirements. These Essentials represent a commitment that required hours prepare a consistent product in terms of breadth of preparation and quality to reinforce confidence in our graduates by nursing practice colleagues, other health professionals, and consumers.
Some learners will achieve select competence outcomes more quickly than others. “One and done,” however, does not demonstrate the progressive and consistent nature of competency attainment and the assessment necessary in nursing professional education. Repetition plays a role in reinforcing previously acquired knowledge, skills, values, and attitudes.
Repetition also allows for intentional and unintentional complexities and context nuances to be introduced, thus building on minimum competence thresholds. Given the paucity of evidence to support specific experience quantities, case numbers, or hourly requirements that should be achieved, a minimum threshold of hours of practice engagement remains necessary at this time.
The specific clinical/practice experiences and number of practice hours and/or credit hours required depends on these Essentials, advanced nursing practice specialty and advanced nursing practice role requirements, and regulatory standards for specialty certifications and licensure.
The program must include adequate experiences (in terms of time, diversity, depth, and breadth) to allow attainment and demonstration of all relevant competencies (Level 2 sub competencies and applicable specialty/role competencies and other requirements) and successful transition to practice demonstrated through program outcomes.
The number of in person practice hours will vary based on student needs and curriculum design. Participation in a minimum of 500 practice hours in the discipline of nursing, post entry-level education, and attainment of Level 1 sub competencies is required for demonstration of the advanced level sub competencies. Some students may require more.
These practice hours also provide a foundation for the additional time-based requirements set by specialty organizations or external licensing/certifying bodies, which will require additional practice time for preparation in advanced nursing specialties or advanced nursing practice roles. Hours of practice do not necessarily need to be outlined by competency type (Essentials or specialty/role).
Some, but not all, Level 2 sub-competencies and/or specialty/role competencies may be demonstrated and assessed concurrently. It is expected that faculty create clinical/practice learning experiences that provide for active learning, repetition, inter professional engagement, and successive levels of difficulty.
As the strength of evidence to support valid and reliable assessment techniques builds, the role of practice experiences and number of hours (eg, time based requirements) may evolve in the future.
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